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Am J Geriatr Psychiatry. 2015 Feb;23(2):215-9. doi: 10.1016/j.jagp.2014.09.003. Epub 2014 Sep 21.

Does cognition predict treatment response and remission in psychotherapy for late-life depression?

Author information

1
Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto VA Health Care System, Palo Alto, CA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA; School of Psychology, University of Queensland, Brisbane, Australia. Electronic address: sherryb@stanford.edu.
2
Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto VA Health Care System, Palo Alto, CA.
3
Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto VA Health Care System, Palo Alto, CA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA; School of Psychology, University of Queensland, Brisbane, Australia.
4
Department of Psychiatry, University of California, San Francisco, CA.

Abstract

OBJECTIVES:

To identify cognitive predictors of geriatric depression treatment outcome.

METHOD:

Older participants completed baseline measures of memory and executive function, health, and baseline and post-treatment Hamilton Depression Scales (HAM-D) in a 12-week trial comparing psychotherapies (problem-solving vs. supportive; N = 46). We examined cognitive predictors to identify treatment responders (i.e., HAM-D scores reduced by ≥50%) and remitters (i.e., post-treatment HAM-D score ≤10).

RESULTS:

Empirically derived decision trees identified poorer performance on switching (i.e., Trails B), with a cut-score of ≥82 predicting psychotherapy responders. No other cognitive or health variables predicted psychotherapy outcomes in the decision trees.

CONCLUSIONS:

Psychotherapies that support or improve the executive skill of switching may augment treatment response for older patients exhibiting executive dysfunction in depression. If replicated, Trails B has potential as a brief cognitive tool for clinical decision-making in geriatric depression.

KEYWORDS:

Intervention; cognitive predictors; depressed; older adults; psychological treatments; treatment outcome

PMID:
25441055
PMCID:
PMC4289644
DOI:
10.1016/j.jagp.2014.09.003
[Indexed for MEDLINE]
Free PMC Article

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